Lesbian Gay Research Articles

Body Uneasiness and Dissatisfaction Among Lesbian, Gay, Bisexual, and Heterosexual Persons

IntroductionWhile sexual minority people have been widely considered at risk for developing a range of body image concerns, evidence of body dissatisfaction and shame amongst LGB (lesbian, gay, and bisexual) individuals is mixed. This study investigated differences in body uneasiness, body dissatisfaction, and self-blaming/attacking attitudes between LGB and heterosexual individuals, as well as within LGB groups, while also examining the predictive role of body mass index (BMI).MethodsA sample of cisgender lesbian women (n = 163), gay men (n = 277), bisexual women (n = 135), bisexual men (n = 39), heterosexual women (n = 398), and heterosexual men (n = 219) completed an online survey assessing different aspects of body image between May and July 2020.ResultsGay and bisexual men reported greater body image disturbance and self-blaming attitudes relative to heterosexual men. In contrast, lesbian women reported lower body uneasiness than their bisexual and heterosexual counterparts, but greater self-hate. Moreover, lesbian and bisexual women showed more body dissatisfaction than gay men, and bisexual individuals reported more body uneasiness than individuals in other sexual minority subgroups. Higher BMI emerged as a significant predictor of body image concerns and dissatisfaction.ConclusionsBody image dimensions showed sexual identity–based differences. Determining the specific nuances of body image in LGB individuals can provide important information on potential risk factors that may impact mental health outcomes.Policy ImplicationsIn-depth knowledge of body dissatisfaction and uneasiness in individuals with LGB identities may have critical implications for the development of personalized prevention and treatment strategies.

Estimated likelihood of parenthood among sexual minority individuals associates with interpersonal vulnerability and traumatic outlook

ABSTRACT Background Lesbian women and gay men (LG) tend to report lower levels of parenthood aspiration than their heterosexual counterparts. While several variables have been suggested to explain this phenomenon, no study has investigated the potential mediating role of interpersonal vulnerability and subjective traumatic outlook in the association between sexual orientation and the estimated likelihood of parenthood. Objective To investigate whether interpersonal vulnerability and subjective traumatic outlook mediate the association between sexual orientation and a lower estimated likelihood of parenthood. Methods A sample of 435 childfree, cisgender Israeli participants, aged 18–49 years (M = 27.82, SD = 4.47), were recruited through convenience sampling. 192 participants self-reported as LG (64 lesbian women and 128 gay men). Participants completed online questionnaires assessing their estimated likelihood of parenthood, interpersonal vulnerability, and subjective traumatic outlook. Mediation analyses were performed using the PROCESS macro. Results LG individuals reported a lower estimated likelihood of parenthood than their heterosexual counterparts. Interpersonal vulnerability and subjective traumatic outlook significantly mediated the association between sexual orientation and a lower estimated likelihood of parenthood. Conclusions Despite improvement in the socio-political climate relating to sexual minority rights and access to fertility technologies, LG individuals are still more likely to report a lower estimated likelihood of parenthood in comparison to heterosexual individuals. Moreover, this gap appears to be partially mediated by interpersonal vulnerability and subjective traumatic outlook. The results contribute to the growing body of international research exploring family formation among sexual minority individuals and are relevant for researchers, clinicians, and policymakers.

Sexual Orientation and Infidelity-Related Behaviors on Social Media Sites

Little research has been focused on offline or online infidelity in GL dating relationships, especially in a post-communist socio-cultural context. Infidelity-related (IR) behaviors on social media sites might be as hurtful to relationships as offline infidelity, both in gay, lesbian (GL) and heterosexual romantic monogamous relationships. In this cross-sectional study, we aimed to examine the associations between dyadic satisfaction, attitudes toward infidelity, and problematic internet usage, with IR behaviors on social media sites among GL and heterosexual unmarried individuals in Romanian sexual minority communities. Results showed that GL respondents did not significantly differ from heterosexual participants regarding IR behaviors. Furthermore, we found the main effect of attitudes toward infidelity and problematic internet use on IR behaviors. Sexual orientation highlights the main effect of IR behaviors when analyzed with dyadic satisfaction. The current study may be a precursor to further research investigating correlations in online IR behavior among lesbian and gay individuals engaging in consensual nonmonogamy. Implications of the findings are discussed in the social context of a post-communist country where GL individuals may face discrimination and stigma because of their sexual orientation.

Mental and sexual health during the COVID-19 pandemic: Differences between lesbian and bisexual women and gay and bisexual men in Mexico

COVID-19 had implications for sexual minorities who faced challenges due to situations related to their sexual orientation. The objective of this article was to analyze the differences in sexual and mental health experiences between lesbian and bisexual women (LBW) and gay and bisexual men (GBM) in Mexico in the context of the pandemic. An online survey captured the mental and sexual health experiences of a total of 932 participants consisting of 720 GBM and 212 LBW with a mean age of 30.5 years. Regarding mental health, women reported higher levels of depression, anxiety, and a greater possibility of suicidal ideation. Regarding sexual health, men were more likely to use drugs during sexual intercourse, have problems getting tested for sexually transmitted infections (STI), and have had STI during the lockdown. These findings identify particularities that each group faced, which can inform recommendations for public policies addressing specific sexual and mental health problems during and after the current pandemic.

Black Transnational Resistance

Look Back at It (2016) is a cutting-edge interpretation of Pablo Picasso’s Les Demoiselles d’Avignon (1907) by African American multidisciplinary artist Rashaad Newsome. The work is a collage of magazine cuttings. The action is set in the vogue ballroom scene, a counterculture sparked in the 1970s by the Black and Latinx Lesbian Gay Bisexual Transgender Queer/Questioning (LGBTQ+) communities in New York. The muses are disenfranchised African American trans women who have faced a long-standing subjugation anchored in America’s history of racial slavery and classed transphobic capitalism. Their bodies are made of a collage of dazzling jewels cut from glossy magazines that have rendered them invisible. Drawing on beauty politics, this article maps the visual repertoire of Newsome’s aesthetic and its geopolitical implications. A formal and contextual analysis highlights how the use of high jewelry alludes to the global trade in minerals—most specifically, the diamond industry’s spoliation of South Africa’s natural resources, pionered by British imperialist Cecil Rhodes. Special attention is paid to the way Newsome’s subversion of the codes of high jewelry visually and conceptually echoes voguers’ transgression of high fashion in dance competitions. Newsome stages a transnational and transhistorical dialogue between two distinct but interconnected systems of oppression, imperialism and global capitalism, thus sketching a collective history of Black pain and of creative resilience, guided by trans women, that is essential at the time of the resurgence of global populist nationalistic discourses.

Lesbian Gay Bisexual Transgender Questioning/Queer Two- Spirit Adolescents and Suicidality

Background: At a time when suicides are increasing throughout the United States, lesbian, gay, bisexual, transgender, and two spirit (LGBTQ2S) adolescents are at especially high risk for suicidal ideation, attempts, and completed suicide. Objectives: To 1) provide an overview and clinical perspective on LGBTQ2S suicidal ideation, attempts, and completed suicide; 2) discuss how the literature maps on to theories of suicide, and also points the way to clinical recommendations; and 3) give recommendations for clinical care based on this evidence. Method: This article uses a narrative review style to discuss the current concerns around LGBTQ2S adolescent suicide. The Social Ecological Model, the Interpersonal Psychological Theory of Suicide, and Minority Stress Theory are used describe the manner in which risks are acquired. Results: Emerging research demonstrates risks and protective factors in the lives of LGBTQ2S adolescents. The social context of LGBTQ2S adolescents puts them at risk for internalizing the experiences of discrimination evident in our society, In addition, there are other risk factors frequently associated with their LGBTQ2S status, such as substance misuse, homelessness, and lack of social support . Adolescents of color are especially vulnerable as they experience multiple marginalizations, often living in under resourced communities with poor access to health care. Support to families can be provided in the form of psychoeducation based on research findings. Social support is crucial and can be effectively provided in schools. Access to mental health care needs to be increased and barriers reduced. Conclusion: There is a need for more research, especially prospective study designs and research that centers adolescents of color and homeless adolescents. While there may be barriers to addressing the current rate of suicidality in this population, clinicians who work with adolescents can use a range of therapies to support their LGBTQ2S adolescent patients and their families, decreasing risk of suicidality.

Stifled from the start: biased allocation of developmental opportunities and the underrepresentation of lesbian women and gay men in leadership

PurposeThe goal of this study was to help explain the underrepresentation of lesbian women and gay men (LG) in senior leadership positions by examining bias in the allocation of developmental opportunities (sponsorship/coaching and challenging work assignments). It further sought to test stigma-by-association as one reason for the biased allocation of developmental opportunities.Design/methodology/approachAn online experimental vignette study (N = 273) using a 2 (target gender: male vs female) by 2 (sexual orientation: LG vs heterosexual) design was conducted.FindingsLG workers were less likely to be allocated developmental opportunities than heterosexual workers overall and relative to their same-sex heterosexual counterparts. Further, lesbian women were least likely to be allocated developmental opportunities. These effects also operated indirectly via participants concerns about stigma-by-association.Originality/valueSexual orientation and gender identity minority workers remain underrepresented in senior leadership positions and oftentimes despite having better objective qualifications. Research has begun examining bias in leader selection. This study, however, directs attention to the biased allocation of developmental opportunities which make one competitive for senior leadership positions and occur prior to leader selection. In doing so, the authors provide a baseline understanding of an important reason why LG might be underrepresented in leadership positions.

Validation of Herek's attitudes toward lesbian women and gay men scale among undergraduates in mainland China.

The lack of a standardized reliable and valid instrument makes it difficult to measure attitudes toward lesbian women and gay men (ATLG) consistently and thus poses a challenge to compare and contrast intervention measures. This study aimed to validate Herek’s ATLG scale among undergraduates in mainland China and identify factors associated with negative attitudes toward LG. A total of 6,036 eligible undergraduates conveniently drawn from 30 provinces across mainland China were randomly split in half. Item analysis was first used to select unrelated or redundant items for deletion. Exploratory factor analysis (EFA) were then conducted on the first half of the sample (n = 3,001), followed by confirmatory factor analysis (CFA) and reliability analysis in the second half (n = 3035). Logistic regression analyses were finally carried out to identify their determinants. Six items were removed from the item analysis. EFA supported the existence of two factors (ATL and ATG). CFA results indicated that the two-factor model fit the data better than the one-factor model. Logistic regression analyses indicated that being female, majoring in non-health-related disciplines, attributing homosexuality to uncontrollable causes, non-adherence to traditional gender norms and exposure to homosexual content were significantly associated with less negative attitudes toward both L and G. Urban students were marginally less likely to express negative attitudes toward L but not G, while non-heterosexuals and those who had prior personal contact with homosexuals exhibited less negative attitudes toward G but not L. However, grade showed no significant associations with either ATL or ATG. The retained 14-item version of Herek’s ATLG scale has been proven to be a reliable and valid tool. Furthermore, ATL and ATG were determined by different factors and thus would be treated separately. In order to reduce negative attitudes toward LG among undergraduates in mainland China, a comprehensive intervention plan such as conducting comprehensive sex education and pushing the process of legalizing same-sex marriage should be designed, implemented and evaluated.

Is Monkeypox Being Underdiagnosed in Countries with More Stigmatizing Attitudes towards Men Who Have Sex with Men? A Simple Ecological Analysis.

It is not known why the recent outbreak of monkeypox (MPX) has been more extensive in certain European countries than others. Previous studies have found that European countries with more stigmatizing attitudes to homosexuality have more undiagnosed HIV infections in men who have sex with men (MSM). We hypothesized that MPX in MSM may be underdiagnosed in European countries with more stigmatizing attitudes to homosexuality and less access to sexually transmitted infection (STI) testing for MSM. To test this hypothesis, we used Spearman’s correlation to assess if the national incidence of MPX in European countries was negatively associated with the intensity of screening for STIs and a composite indicator of Lesbian Gay Bisexual Transgender Intersex (LGBTI) rights (the Rainbow Index). We found that the national cumulative incidence of MPX was positively correlated with the intensity of chlamydia/gonorrhoea screening (rho 0.68, p-value < 0.0001), syphilis screening (rho 0.62, p-value < 0.0001), and the Rainbow Index (rho 0.65, p-value < 0.0001). Our analysis thus suggests caution is required in interpreting the relatively lower incidence of MPX reported from several Eastern European countries. A key limitation of this analysis is that the incidence of MPX was calculated in the whole population and not limited to the MSM population.

Understanding the Health and Health-Related Social Needs of Youth Experiencing Homelessness: A Photovoice Study.

Purpose: Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and health-related social needs of youths experiencing homelessness during the coronavirus disease (COVID-19) pandemic. Methods: A total of 14 youths between the ages of 14 and 24 who (a) lived, worked, or attended school in New Britain, Connecticut (CT) and (b) had at least one experience of homelessness or housing insecurity worked with the research team to conduct a needs assessment regarding youth homelessness. Using photovoice, a community-based participatory research method, participants created photo narratives to share their stories and recommendations for community change. The main goals of photovoice are to enable participants to (1) record and represent their everyday realities; (2) promote critical dialogue and knowledge about person and community strengths and concerns; and (3) reach policy makers. Results: Most of the participants identified as youths of color, and half of the participants identified as members of the LGBTQ+ community. Three major themes that appeared in the youths’ narratives include the following: mental health and substance use challenges, trouble accessing basic human needs, and lack of a social support system. Conclusion: This study uplifts and empowers a vulnerable population to increase visibility around a major public health challenge from their own lived experiences. Despite the challenges that were voiced, many participants shared a sense of hope and resiliency. The major themes endorsed by the youths has the potential of informing practitioners and policy makers of how to better address the needs of youths experiencing homelessness, particularly those most at risk.

O-282 Is the poly parenthood the new type of parenthood?

Abstract Is multi-parenthood the new type of parenthood? Conceiving and raising a child with someone who is not a committed conjugal partner has long been disapproved of and is still regarded by some with concern or disdain. However, this way of having children, also referred to as ‘co-parenting’, has increasingly become a family-building option in itself. Originally describing the cooperation of parents in raising their children after divorce, this term now also designates people who deliberately pursue this type of family arrangement and commit to raising a child together, possibly with their respective partners. This parental path is usually chosen to provide a child with a mother and a father with whom they can develop long-lasting relationships. This paper explores some of the opportunities and challenges presented by co-parenting involving more than two parental figures, by focussing on the experiences and accounts of lesbian women and gay men engaged in such family arrangements in Belgium. Drawing on work by social theorists of the family, the main features and advantages of these arrangements are examined to show that while co-parenting might at first seem marginal and complicated, it appears particularly well adapted to contemporary social constraints and parenting expectations. It can facilitate the achievement of a number of ideals and expectations valued in contemporary society, including: the biological heteronormativefamily model; the possibility to negotiate and implement reflexive parentalpractices; the need for a committed but personalised parenthood; and the desire for a betterand more flexible life-balance. Despite these advantages for those involved, multi-parental arrangements raise a set of social, ethical and legal questions that challenge broader legal and ideological family norms.

Disparities in Mental Health and Health Risk Behaviors for LGBT Veteran Subgroups in a National U.S. Survey.

Purpose: This study examined differences in mental health and health risk behaviors across sexual orientation and gender identity among U.S. veterans. Methods: Veterans were recruited through targeted social media advertising, community organizations, and listservs to complete an online survey (N = 1062). Generalized linear regression was used to evaluate differences in outcomes between subgroups, which included cisgender heterosexual men and women, lesbian women, gay men, bisexual men and women, transgender men and women, and veterans with other gender identities. Results: Transgender men and women reported a significantly higher prevalence of lifetime suicide plans and attempts compared to all other subgroups within the respective genders. Beyond this finding, patterns of all outcomes varied by gender. Compared to other subgroups of men, transgender men reported higher prevalence of posttraumatic stress disorder, whereas cisgender gay men reported higher prevalence of lifetime cocaine use and positive human immunodeficiency virus (HIV) status. Within the women subgroups, all LGBT subgroups reported higher prevalence of lifetime smoking and past-year marijuana use compared to heterosexual women. Cisgender lesbian women also reported higher prevalence of past-month heavy episodic drinking, and cisgender bisexual women reported higher prevalence of lifetime cocaine and stimulant use compared to other groups. Conclusion: Transgender women and men reported significantly higher prevalence of lifetime suicide plans and attempts than other groups, highlighting this as an area in need of urgent public health attention. Other disparity patterns indicated the importance of examining subgroups within the LGBT veteran community.

The Influence of Social Media Social Support on the Flourishing Homosexual Identity: A Case Study of the Lesbian Gay Bisexual Transgender Queer (LGBTQ) Community in Accra-Ghana

The aim of the study was to explore the influence of social media and social support on the flourishing homosexual identity in Accra, Ghana. The objectives were to determine the extent to which social support influence’s homosexual identity, the correlation between homosexual identity and flourishing levels among homosexuals, to ascertain the extent to which media, emotional, and social support predicts how homosexuals flourish, and finally to as certain how differences in the level of education predict how homosexuals flourish in Accra, Ghana. A case study design was employed. The population for this study was associates of the homosexual Community in Accra-Ghana. Using a purposive sampling technique, 142 homosexual respondents answered a standard questionnaire. Berlin Social Support scale (BSSS), Diener Flourishing scale Lesbian, Gay, and Bisexual Identity Scale were used on demographics, social support, flourishing, and lesbian, gay, bisexual identity. Data was analysed using simple linear regression, Pearson product-moment correlation coefficient, and one-way analysis of variance. Results obtained indicated that social support does not predict homosexual identity among homosexuals in Accra. As an individual homosexual identity increases so does the level with which the individual flourishes. Thirdly, social media emotional, and social support was found to be a predictor of flourishing among homosexuals in Accra. Finally, the results also indicated that differences in the level of education do not predict how homosexuals flourish in Accra. The conclusion indicates that study has shown that differences in the level of education among homosexuals do not influence the extent to which homosexuals flourish.

Experiences of informal caregiving among older lesbian and gay adults in Australia.

ObjectiveThis study examined older lesbian and gay adults' experiences regarding informal caregiving, including challenges and positive aspects of caregiving.MethodsInterviews were conducted with 16 lesbian women and gay men in Australia, aged 60+, who were engaged in informal caregiving. Analyses involved a qualitative thematic approach.ResultsMost participants were caring for a friend or partner and regarded caregiving as a form of love and did not seek external support despite noting several impacts. Some participants found that they too were beginning to require care. For some, formal care was being considered, but with a degree of reluctance.ConclusionsOlder lesbian and gay adult caregivers experience a range of challenges and support needs in relation to their experiences with the caregiving role. This research highlights a need for ensuring that caregiving policies and practices be responsive to the experiences and challenges faced by older lesbian and gay people.

Exploring kinship and the desire to be parents in Spanish same-sex couples

Empirical evidence has settled controversy over the effect on children of being raised by same-sex parents. However, other issues have emerged that are related to this family model. The aim of this study was to identify discourses linked to the desire to be parents and to the construction of kinship in lesbian women and gay men parents. We analysed a documentary project (‘Familiarízate’) produced in Spain by the Spanish national Federation of Lesbians, Gays, Transsexuals, and Bisexuals. We found that the narrative on the desire to be parents was mainly shaped by previously established definitions of marriage and family. We also identified a set of interesting paradoxes and tensions in some of the discourses that challenged traditional models of family and kinship.

The Role of Family Support in Gay and Lesbian Individuals’ Experiences of Sexual Identity-Based Discrimination, Harassment, and Violence: An Empirical Test of Norm-Centered Stigma Theory

ABSTRACT Many gay and lesbian individuals struggle with family support throughout their life course. In addition, due to their differences in social power and violations of heteronormativity, gay men and lesbian women have unique experiences with family distress. Such difficulties can be related to an increased risk for sexual identity-based discrimination, harassment, and violence (DHV) among gay and lesbian individuals, yet few studies have examined these relationships. The current study utilizes data stratified by US Census categories (age, gender, race/ethnicity, and census region) collected from online panelists (N = 2159; n = 750 hetero cis men, n = 749 hetero cis women, gay cis men = 330, lesbian cis women = 330) to explore Norm-Centered Stigma Theory (NCST) and the relationships between gay/lesbian identity and sexual identity-based DHV. Specifically, social power axes (gender identities), family support, and interactions among these are investigated as they moderate the relationships between violations of heteronormativity (gay/lesbian identity) and stigmatizing experiences associated with such norm violations (sexual identity-based DHV). Results indicate that gay/lesbian identity increases the likelihood of experiencing sexual identity-based DHV; however, family support among lesbian women and gay men decreases the odds of experiencing sexual identity-based DHV. Overall, results lend support to the use of NCST in intersectional explorations to better understand gay and lesbian experiences.

Sexual orientation differences in pathways from sociocultural and objectification constructs to body satisfaction: The U.S. Body Project I

Objectification theory and the tripartite influence model provide useful frameworks for understanding the body image experiences of men and women. However, there is little systematic investigation of how sexual orientation moderates the links between these constructs and body image satisfaction. It has been hypothesized, for example, that the associations of surveillance (i.e., monitoring of one’s appearance due to objectification by others) would be strongest for groups targeted by the male gaze (e.g., gay men, lesbian women, and bisexual men and women). Here we proposed an integrated sociocultural model and examined these pathways in multigroup structural equation models in a national sample of heterosexual, bisexual, and lesbian women (ns = 5395; 598; 213, respectively), and heterosexual, bisexual, and gay men (4869; 194; and 194, respectively) aged 18–65 years. Sexual orientation moderated some of these pathways. The most consistent pattern was that appearance pressures were internalized to a greater extent among bisexual participants. The pathways to poorer body image were generally similar among heterosexual and gay/lesbian men and women. These findings highlight the importance of examining sexual orientation-specific influences on body image across diverse groups, as well as the commonalities in the experiences of men and women across sexual orientations.

Mental health in people with minority sexual orientations: A meta-analysis of population-based studies.

To conduct a meta-analysis of population-based studies to quantify the association between sexual minority status (lesbian women, gay men, and bisexual people) and the risk of common mental disorders (depressive disorders, alcohol use disorders (AUD), anxiety disorders, and suicidality). PubMed, PsycInfo, Web of Science, the Cochrane Library Database, the Applied Social Sciences Index and Abstracts, and ProQuest were searched for relevant studies published between 2000 and May 2020. The PRISMA guidelines were followed for selection processes. Twenty-six studies met the inclusion criteria which included a total of 519,414heterosexuals, 10,178lesbian/gay people and 14,410 bisexual people. Lesbian/gay people (ORs between 1.97, 95% [CI=1.76, 2.19] and 2.89, 95% [CI=2.41,3.38]) and bisexual people (ORs between 2.70; 95% [CI=2.21,3.18], and 4.81; 95% [CI=3.63, 5.99]) had a higher risk for mental disorders than heterosexuals for all investigated diagnostic categories. The risk for depression (OR=2.70; 95% [CI=2.21, 3.18]) and suicidality (OR=4.81; 95% [CI=3.63, 5.99]) was higher in bisexual compared with lesbian/gay people. Exploratory meta-regressions revealed no evidence for a decrease in mental health differences between people with minority sexual orientations and heterosexuals in more recent years of data assessment, except for AUD. These findings clearly suggest disparities in mental health between people with minority sexual orientations and heterosexual people. There is a lack of data regarding a wider spectrum of sexual orientations and mental disorders and studies in non-Western countries.

“Our feelings are valid” – reviewing the lesbian, gay, and bisexual affirmative approaches in a mental health setting

In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.

Lesbian Gay Bisexual Transgender and Queer Health-Care Experiences in a Military Population

ABTRACT This study aimed to understand the experiences of lesbian, gay, bisexual, transgender, and queer of former military service members. Data for this analysis was collected from the two open-ended survey questions as part of a larger online survey. The analysis was performed using the web-based data analysis application Dedoose. Eighty-eight qualitative responses were used. Analysis of the responses revealed five main themes: (1) identity, (2) negative experiences, (3) impact of experiences, (4) policy, and (5) positive experiences. These findings can influence future military research by focusing on the effects of the Don’t Ask Don’t Tell policy, negative and positive experiences, and the impact of those experiences.